Healthcare Provider Details
I. General information
NPI: 1285503540
Provider Name (Legal Business Name): VASS MEDICAL SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 N ASHLAND AVE APT 1N
CHICAGO IL
60622-5684
US
IV. Provider business mailing address
830 N ASHLAND AVE APT 1N
CHICAGO IL
60622-5684
US
V. Phone/Fax
- Phone: 773-280-7001
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMIP
MORKER
Title or Position: MEMBER
Credential: DO
Phone: 773-280-7001